The new year is a great time to look at vitamins and minerals essential for good health. This month we are going to start with magnesium: why we need it and where we get it.

WHY IS MAGNESIUM IMPORTANT?

Magnesium is the fourth-most abundant mineral in the body. It is essential for energy production, normal nerve and muscle function, strong bones, a healthy immune system, and a regular heart rhythm.

Magnesium helps regulate blood-sugar levels and promotes normal blood pressure. It also is known to be involved in protein synthesis.

Data from the 1999-2000 National Health and Nutrition Examination Survey suggests that substantial numbers of adults in the United States fail to get recommended amounts of magnesium in their diets. Deficiency is especially common in women, blacks and the elderly.
In the hospital, low magnesium occurs in 12 percent of patients, and that number increases to as high as 60 percent to 65 percent in the intensive care unit.

WHAT FOODS HAVE MAGNESIUM?

Magnesium is well absorbed from food, but you need to have adequate vitamin D for absorption. Foods high in fiber are generally high in magnesium, like legumes (peas and beans), whole grains, vegetables (especially broccoli, squash and green leafy vegetables), and seeds and nuts (especially almonds). Refined white flours have had the magnesium processed out of them.

SIGNS OF DEFICIENCY

Often a patient will have some constellation of symptoms that show there is a good chance they have magnesium deficiency. These signs include constipation; muscle pain; asthma; palpitations (extra heart beats); sleep disorders (including restless legs); hypertension; and headaches.

MEASURING MAGNESIUM

Since only 1 percent of magnesium is found in blood (the rest is in bone and other tissues), blood levels do not tell us much about our magnesium status. Blood tests are only low in severe deficiency.

In the outpatient setting, we often will supplement with magnesium, gradually increasing till having loose stools. Some people will measure red cell magnesium or cellular magnesium from a mouth swabbing.

MAGNESIUM AND MEDICATION

Many drugs can decrease your magnesium. Some of the most common are Beta2-agonists (often used for asthma, like albuterol, Serevent), digoxin (for heart failure) and some diuretics (used for high blood pressure).

In 2011, the U.S. Food and Drug Administration issued a safety warning that patients on proton pump inhibitors (medication for stomach acid) may have low magnesium.

USES IN ILLNESS

There is evidence that magnesium can be used for nerve pain associated with cancer treatment, chronic fatigue syndrome, cluster and migraine headaches, angina, fibromyalgia, osteoporosis, and premenstrual syndrome.

The take-home message for this month is magnesium deficiency is common — and more so on certain medications and with high-risk groups, like women, blacks, seniors and hospitalized patients. Eating whole foods — such as unprocessed grains, fruits and vegetables, and nuts and seeds — can prevent it.

So start the new year right by being mindful of what you eat and prevent magnesium deficiency.